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1851345136

NPI Code Detail

MEDICARE: DR. KWAN IL LEE M.D.

MEDICARE: DR. KWAN IL LEE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	MD038496L	PA
2	207L00000X	Anesthesiology Physician	MD038496L	PA
3	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	MD038496L	PA
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	MD038496L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	161462	OTHER	PA	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851345136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KWAN IL LEE M.D.

Provider Business Mailing Address
First Line	:	107 BROOKSIDE LN
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-9785
Country	:	US
Telephone Number	:	412-788-4312
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 HOSPITAL DR
Second Line	:
City	:	ALIQUIPPA
State	:	PA
Zip	:	15001-2123
Country	:	US
Telephone Number	:	724-857-1212
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	09/11/2025

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Directions to “ DR. KWAN IL LEE M.D.” Practice Location

Language	Start Address	Practice Location

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